COVID-19 and Cognitive Decline in Older Adults with High-Cardiovascular Risk: A Post Hoc Analysis.

Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (ßadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.

Characteristics of the phenotypes in prevalent and incident cases of heart failure in primary care: IBERICAN study.

BACKGROUND: The management in primary care (PC) of the patients with Heart Failure (HF) is different from the management hospital, in a special way compared to cardiology departments. OBJECTIVE: To define the characteristics in both phenotypes of HF in prevalent and incident cases of HF in patients recruited in a large PC sample. METHODS: We proposed a and longitudinal analyses, in patients of the IBERICAN cohort, that recruited 8,066 patients in the Spanish primary care system, with 15,488 patients-years of follow-up. Of them, 252 patients (3.1%) had diagnoses of HF. HF was classified according to the 2014 guidelines in two groups: HF with a reduced eject fraction or HFrEF (LVEF < 50%) and HF with preserved eject fraction or HFpEF (LVEF ≥ 50%). Recommended treatment was defined as the patient receiving drug treatment with Renin-Angiotensin-System (RAS) blockers with beta-blockers and, optionally, spironolactone. The incidence of new cases of HF was calculated in the 7,814 patients without HF in the inclusion visit. Finally, we analysed which variables associated the onset new cases and get the hazard ratio (HR) with the confidence interval at 95% ([95%CI]). Clinical trials register: NCT02261441 (02/05/2017). RESULTS: The HFpEF was the most frequent phenotype in prevalent cases (61.1%) and incident cases (73.9%). Patients with HFrEF had a higher prevalence of coronary heart disease (p = 0.008) and PAD (p = 0.028), and no statistically significant differences was observed in the therapeutic groups used between both groups. The incidence of HF was 12.8 cases/1000 inhabitants/year, 35.6% of them was diagnosed in PC. The renin-angiotensin system blockers were more used in PC (60%) and beta-blockers (100%) and spironolactone (60%) in hospital. The female sex showed a protective effect for incident cases (0.51 [0.28-0.92]); and AF (HR [95%CI]: 2.90 [1.51-5.54]), coronary heart disease (HR [95%CI]: 2.18 [1.19-4.00]) and hypertension (HR [95%CI]: 1.91 [1.00-3.64]) increased the risk of developing HF. CONCLUSIONS: HF phenotype more frequent and incident in PC was the HFpEF, but only one third of them are diagnosed in PC level. The female sex showed a protective effect and atrial fibrillation, ischaemic heart disease and hypertension increased the risk of develop HF.

More Adult Women than Men at High Cardiometabolic Risk Reported Worse Lifestyles and Self-Reported Health Status in the COVID-19 Lockdown.

BACKGROUND: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. METHODS: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. RESULTS: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). CONCLUSIONS: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.

Association between diet quality and malnutrition: pooled results from two population-based studies in older adults.

BACKGROUND: The role of diet quality on malnutrition in older adults is uncertain, due the paucity of the research conducted and the use of use of screening tools that did not consider phenotypic criteria of malnutrition. OBJECTIVE: To evaluate the association of two indices of diet quality, namely the Mediterranean Diet Adherence Screener (MEDAS) and the Alternative Healthy Eating Index (AHEI-2010), with malnutrition among community-dwelling older adults in Spain. METHODS: Cross-sectional analysis of data from 1921 adults aged ≥ 60 years from the Seniors-ENRICA-1 (SE-1) study, and 2652 adults aged ≥ 65 years from the Seniors-ENRICA-2 (SE-2) study. Habitual food consumption was assessed through a validated diet history. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) phenotypic criteria. Statistical analyses were performed with logistic regression with adjustment for socioeconomic and lifestyle variables as well as for total energy and protein intake. RESULTS: The prevalence of malnutrition in the SE-1 study was 9.5% (95% confidence interval: 8.2 to 10.9) and 11.7% (10.5 to 13.9) in the SE-2. Adherence to the MEDAS score was associated with lower prevalence of malnutrition [pooled odds ratio for high (≥ 9 points) vs. low adherence (< 7 points): 0.64 (0.48-0.84); p-trend < 0.001]. Higher adherence to the AHEI-2010 also showed an inverse association with malnutrition (pooled odds ratio for quartile 4 vs. 1: 0.65 (0.49-0.86); p-trend 0.006). Among the individual components, higher consumption of fish and long-chain n-3 fatty acids in MEDAS and AHEI-2010, and of vegetables and nuts and legumes in AHEI-2010, and lower intake of trans-fat and sugar-sweetened beverages and fruit juice in AHEI-2010 were independently associated with lower odds of malnutrition. CONCLUSION: Adherence to high diet-quality patterns was associated with lower frequency of malnutrition among older adults. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov identifier: NCT02804672. June 17, 2016.; ClinicalTrials.gov NCT03541135. May 30, 2018.

Environmental impact of the diet of young Portuguese and its relationship with adherence to the Mediterranean Diet.

OBJECTIVE: To estimate, in a cohort of young Portuguese adults, the environmental impact (greenhouse gas (GHG) emissions, land use, energy used, acidification and potential eutrophication) of diet according to adherence to the Mediterranean Diet (MD). METHODS: Data from 1554 participants of the Epidemiologic Health Investigation of Teenagers in Porto (EPITeen) were analysed. Food intake and MD adherence were determined using validated questionnaires. The environmental impact was evaluated with the EAT-Lancet Commission tables, and the link between MD adherence and environmental impact was calculated using adjusted multivariate linear regression models. RESULTS: Higher adherence (high vs. low) to the MD was associated with lower environmental impact in terms of land use (7.8 vs. 8.5 m2, p = 0.002), potential acidification (57.8 vs. 62.4 g SO2-eq, p = 0.001) and eutrophication (21.7 vs. 23.5 g PO4-eq, p < 0.001). Energy use decreased only in the calorie-adjusted model (9689.5 vs. 10,265.9 kJ, p < 0.001), and GHG emissions were reduced only in a complementary model where fish consumption was eliminated (3035.3 vs. 3281.2 g CO2-eq, p < 0.001). Meat products had the greatest environmental impact for all five environmental factors analysed: 35.7% in GHG emissions, 60.9% in energy use, 72.8% in land use, 70% in acidification and 61.8% in eutrophication. CONCLUSIONS: Higher adherence to the MD is associated with lower environmental impact, particularly in terms of acidification, eutrophication, and land use. Reducing meat consumption can contribute to greater environmental sustainability.

Fine-mapping analysis including over 254,000 East Asian and European descendants identifies 136 putative colorectal cancer susceptibility genes.

Genome-wide association studies (GWAS) have identified more than 200 common genetic variants independently associated with colorectal cancer (CRC) risk, but the causal variants and target genes are mostly unknown. We sought to fine-map all known CRC risk loci using GWAS data from 100,204 cases and 154,587 controls of East Asian and European ancestry. Our stepwise conditional analyses revealed 238 independent association signals of CRC risk, each with a set of credible causal variants (CCVs), of which 28 signals had a single CCV. Our cis-eQTL/mQTL and colocalization analyses using colorectal tissue-specific transcriptome and methylome data separately from 1299 and 321 individuals, along with functional genomic investigation, uncovered 136 putative CRC susceptibility genes, including 56 genes not previously reported. Analyses of single-cell RNA-seq data from colorectal tissues revealed 17 putative CRC susceptibility genes with distinct expression patterns in specific cell types. Analyses of whole exome sequencing data provided additional support for several target genes identified in this study as CRC susceptibility genes. Enrichment analyses of the 136 genes uncover pathways not previously linked to CRC risk. Our study substantially expanded association signals for CRC and provided additional insight into the biological mechanisms underlying CRC development.

Impact of neurofibromatosis type 1 on quality of life using the Skindex-29 questionnaire quality of life in NF1.

BACKGROUND: Neurofibromatosis type 1 (NF1) is one of the most common RASopathies predisposing affected patients to melanic lesions and benign tumors. NF1 is associated with considerable esthetic and functional burden negatively affecting the patient's quality of life (QoL). This study aims to assess the clinical features of NF1 patients and evaluate their impact on QoL. We identified NF1 patients from a public health database of a region in Spain. All patients underwent clinical and ophthalmological evaluation for NF1 features. We measured QoL using the Spanish version of the Skindex-29. RESULTS: Forty patients fulfilled the NF1 National Institute of Health criteria when we recruited patients. The median age was 42.00 years (IQR 26.5 -53.75). The median total Skindex-29 score was 12.3 (IQR 5.9-22.4); (emotion: 15.0, IQR 5.0-37.5; symptoms 8.9, IQR 0.0-17.9 and functioning 8.3; IQR 0.5-18.3). Women and NF1 patients with lower educational levels were associated with poorer QoL scores. We identified itching and sleep troubles to influence NF1 patients' QoL negatively. CONCLUSION: NF1 considerably influences the psychological well-being of NF1 patients. We observed that female and low-educated patients scored higher on the emotional dimension of the Skindex-29 and could, therefore, be more at risk of depression. We also pointed out some "minor symptoms" that negatively impact NF1 patients' QoL such, as itching and sleep troubles which doctors could treat if sought by doctors.

Clinical characteristics, treatment, and blood pressure control in patients with hypertension seen by primary care physicians in Spain: the IBERICAN study.

Objectives: To determine the clinical profile, according to the history of hypertension, the risk of developing hypertension, current antihypertensive treatment and BP control rates in patients with hypertension from the IBERICAN cohort. Methods: IBERICAN is an ongoing prospective cohort study, whose primary objective is to determine the frequency, incidence, and distribution of CVRF in the adult Spanish population seen in primary care settings. This analysis shows the baseline clinical characteristics of patients with hypertension. Adequate BP control was defined as BP <140/90 mmHg according to 2013 ESH/ESC guidelines. Results: A total of 8,066 patients were consecutively included, of whom 3,860 (48.0%) had hypertension. These patients were older (65.8 ± 10.9 vs. 51.6 ± 14.7 years; p < 0.001), had more cardiovascular risk factors, target organ damage and cardiovascular disease (CVD) in comparison with those without hypertension. The risk of hypertension increased with the presence of associated CV risk factors and comorbidities, particularly diabetes, obesity and the metabolic syndrome, and decreased with the intensity of physical activity. Regarding antihypertensive treatments, 6.1% of patients did not take any medication, 38.8% were taking one antihypertensive drug, 35.5% two drugs, and 19.6% three or more antihypertensive drugs. Overall, 58.3% achieved BP goals <140/90 mmHg. A greater probability of BP control was observed with increasing age of patients and the greater number of antihypertensive drugs. Blood pressure control was lower in hypertensive patients with diabetes, obesity, the metabolic syndrome, increased urinary albumin excretion, higher pulse pressure, and lack of antihypertensive treatment. Conclusions: About half of patients attended in primary care settings have hypertension in Spain. Patients with hypertension have a worse CV clinical profile than non-hypertensive patients, with greater association of CVRF and CVD. Around four out of ten patients do not achieve the recommended BP goals, and higher use of combination therapies is associated with a better BP control.

Análisis de las estrategias dirigidas a aumentar la cobertura de vacunación antigripal en personas de 65 años y más / Analysis of strategies aimed at increasing influenza vaccination coverage in people aged 65 and over

Objetivo: Identificar las iniciativas más efectivas para potenciar la vacunación en personas ≥65 años en España.Métodos: Estudio observacional transversal a partir de una encuesta a socios de la Sociedad Española de Médicos de AtenciónPrimaria (n=371). Análisis descriptivo y multivariante de 21 potenciales estrategias de fomento de la vacunación.Resultados: Recomendar la vacunación (15,3%), medios de comunicación/redes sociales (11,5%) y captación activa (10,4%) sepercibieron como las medidas más eficaces. En el análisis multivariante, las de impacto positivo sobre la vacunación fueron:recomendaciones profesionales/institucionales (+23,8 puntos porcentuales, pp), detección oportunista (13,9 pp), recordatorioinformático de registro (10,6 pp), registro de personas no vacunadas (9,1 pp), facilitación de solicitud de citas (8,9 pp) e inclusiónde nuevas estrategias en la cartera de servicios (6,9 pp).Conclusiones: Las medidas más efectivas para este colectivo incluyen acciones a nivel macro, meso y micro para facilitar el accesoa la vacuna, explotando el potencial de las nuevas tecnologías.(AU)

Objective: To identify the most effective initiatives to promote vaccination in people aged ≥65 years in Spain.Methods: Cross-sectional observational study based on a survey of members of the Spanish Society of Primary Care Physicians(n=371). Descriptive and multivariate analysis of 21 potential vaccination promotion strategies.Results: Recommending vaccination (15.3%), media/social networks (11.5%) and active recruitment (10.4%) were perceived asthe most effective measures. In multivariate analysis, those with a positive impact on vaccination were: professional/institutionalrecommendations (+23.8 percentage points, pp), opportunistic screening (13.9 pp), computerised registration reminder (10.6 pp), registration of unvaccinated persons (9.1 pp), facilitation of appointment request (8.9 pp) and inclusion of new strategies in theservice portfolio (6.9 pp).Conclusions: The most effective measures for this group include actions at macro, meso and micro levels to facilitate access to thevaccine, exploiting the potential of new technologies.(AU)

Prevalencia de la enfermedad renal crónica y factores asociados en la población asistida en atención primaria de España: resultados del estudio IBERICAN / Prevalence of chronic kidney disease and associated factors in the Spanish population attended in primary care: Results of the IBERICAN study

Objetivos: Conocer la prevalencia de enfermedad renal crónica (ERC) y determinar los factores asociados al deterioro de la función renal en población asistida en atención primaria.Pacientes y métodoEstudio transversal y multicéntrico realizado en los pacientes basales del estudio IBERICAN (identificación de la población española de riesgo cardiovascular y renal). Se consideró ERC a un filtrado glomerular estimado (FGe)<60ml/min/1,73m2 o albuminuria elevada (≥30mg/g). Según el FGe se clasificó la ERC en 6 estadios (1, 2, 3a, 3b, 4 y 5) y según la albuminuria en 3 (A1 o normal/ligeramente aumentada, A2 o moderadamente aumentada y A3 o gravemente aumentada). Se analizaron las características clínicas y la relación de la ERC con los principales factores de riesgo cardiovascular (FRCV) y otras variables de interés mediante regresión logística no condicional.ResultadosSe incluyeron 7.895 pacientes (edad media 57,9±14,8 años; 54,5% mujeres). El 14,4% (IC 95%: 13,6-15,1) presentaba ERC; en hombres un 16,1% (IC 95%: 14,9-17,3) y en mujeres un 12,9% (IC 95%: 11,9-14,0). Se observó un aumento continuo de la prevalencia con la edad (24,8%≥65años) y con la agregación de FRCV. Las variables que más se asociaron a la probabilidad de padecer ERC fueron hipertrofia ventricular izquierda (OR: 1,95; p<0,001), diabetes (OR: 1,58; p<0,001) e hipertensión (OR: 1,56; p<0,001).ConclusionesCatorce de cada 100 pacientes incluidos en el estudio IBERICAN presenta ERC. La prevalencia de ERC afecta a la cuarta parte de pacientes≥65 años y aumenta exponencialmente con la agregación de FRCV. (AU)

Objectives: To determine the prevalence of chronic kidney disease (CKD) and the factors associated with impaired renal function in the population attended in primary care (PC).Patients and methodCross-sectional and multicentre study carried out in the baseline patients of the IBERICAN study (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). CKD was considered with an estimated glomerular filtration (eGF) <60ml/min/1.73 m2 or elevated albuminuria (≥ 30mg/g). According to the eGF, the CKD was classified in six stages (1, 2, 3a, 3b, 4 and 5) and according to albuminuria in three stages (A1 or normal / slightly increased, A2 or moderately increased and A3 or severely increased). The clinical characteristics and the relationship of CKD with the main cardiovascular risk factors (CVRF) and other variables of interest were analysed using unconditional logistic regression.Results7,895 patients were included (mean age 57.9±14.8 years; 54.5% women). 14.4% (95% CI: 13.6-15.1) had CKD; 16.1% (95% CI: 14.9-17.3) in men and 12.9% (95% CI: 11.9-14.0) in women. A continuous increase of the prevalence was observed with age (24.8% in≥65 years) and with CVFR aggregation. The variables that were most associated with the probability of suffering CKD were left ventricular hypertrophy (OR: 1.95; p <.001), diabetes (OR: 1.58; P<.001) and hypertension (OR: 1.56; P<.001).ConclusionsFourteen out of every 100 patients included in the IBERICAN study have CKD. The prevalence of CKD affects a quarter of patients ≥ 65 years and increases exponentially with the aggregation of FRCV. (AU)

Relación entre el consumo de tabaco y la práctica deportiva en una población universitaria de ciencias de la salud y la educación / Relationship between tobacco consumption and sport practice among health and education science university students

OBJETIVO: Identificar la prevalencia y relación entre práctica deportiva y tabaquismo en estudiantes universitarios españoles vinculados a la salud o la educación. MÉTODOS: Estudio de carácter transversal, en el que 540 estudiantes (edad media de 21,3±3,8 años; 68% mujeres) que cursaban titulaciones vinculadas a la salud (Fisioterapia y Enfermería), y a la educación (Educación Infantil, Educación Primaria y Ciencias de la Actividad Física y del Deporte) contestaron un cuestionario «ad hoc» sobre la práctica de actividad deportiva y el consumo de tabaco. RESULTADOS: Se observó un menor nivel de práctica deportiva y un mayor consumo de tabaco en las mujeres, con independencia de la titulación analizada. En relación a la práctica deportiva el porcentaje medio de estudiantes que reconocieron realizarla fue significativamente menor en aquellos vinculados a la salud (37,7 vs.57,5%). En cuanto al consumo de tabaco, los estudiantes vinculados a la salud reportaron una menor prevalencia (16,7%) siendo la misma del 25,9% entre los estudiantes vinculados a la educación. Los análisis bivariantes indicaron una tendencia a una menor práctica deportiva en los fumadores, pero solo estadísticamente significativa entre los consumidores moderados. CONCLUSIÓN: Existe una baja prevalencia de la práctica deportiva entre estudiantes universitarios de titulaciones vinculadas a la salud, presentando por el contrario los vinculados a la educación un consumo de tabaco más relevante. Parece necesario desarrollar políticas de promoción de hábitos saludables, que se aconseja tengan en cuenta el consumo de tabaco que el estudiante reporte

OBJECTIVE: To identify the prevalence and relationship between the practice of sports and smoking in university students enrolled on accredited qualifications related to health and/or education sciences. METHODS: Cross-sectional study including 540 students (average age of 21.3±3.8 years; 68% women) of the University of Vigo registered in degree programs linked to health (Physical Therapy and Nursing), or education (Pre-School, Primary School and Physical Activity and Sport Sciences) who answered an 'ad hoc' questionnaire relating sports practice and tobacco consumption. RESULTS: Women showed a lower habit on sports practice and a higher tobacco consumption, regardless of their academic degree. The average share of students who recognized practicing sports was significantly minor in those enrolled in health careers (37.7 vs.57.5%). Regarding tobacco consumption, the students enrolled in health careers reported the lowest prevalence (16.7%). Among the students associated to education, this prevalence was found to be 25.9%. The bivariate analysis showed a trend towards a lower sport practice among the smokers. This association was significant only among the moderate consumers. CONCLUSIONS: The findings of this research show a low prevalence in sports practice among students enrolled in degrees associated to health, and a more relevant tobacco consumption among those enrolled in degrees associated to education. It seems necessary to develop strategies aimed at promoting healthy habits that should be taking into account the tobacco consumption reported by the student

Incidencia hospitalaria, tendencia y distribución municipal del cáncer de próstata en el área de salud de León (1996-2010) / Hospital incidence, trends and municipal distribution of prostate cáncer in health área of León, Spain (1996-2010)

El cáncer de próstata (CaP) es el de mayor incidencia entre los varones y sin embargo se conoce muy poco sobre sus factores de riesgo. El presente artículo tiene por objetivo conocer la incidencia hospitalaria, tendencia y distribución municipal del CaP en el área de salud de León (ASL). Métodos. Fueron incluidos los casos nuevos de cáncer de próstata (CIE-9: 185, CIE-10: C61) del registro hospitalario de tumores del Complejo Asistencial Universitario de León, entre 1996 y 2010 en sujetos con residencia en el ASL. Se calcularon las incidencias hospitalarias brutas trienales y ajustadas a población mundial y europea. Como denominador se utilizaron los datos del Instituto Nacional de Estadística de población desagregada por grupos quinquenales de edad de residentes en municipios del ASL. Para el análisis de la distribución espacial se estimaron los riesgos relativos (RR) municipales suavizados mediante el ajuste del modelo de Besag, York y Mollié y sus probabilidades posteriores de que los RR fuesen > 1 (PP), utilizando métodos bayesianos. Resultados: Se incluyeron 3.366 casos. Las tasas estandarizadas con población europea ascendieron de 30,3 (1996-98) a 119,0 (2008-2010) casos nuevos por 100.000 hombres. El número de casos órgano-confinados pasó de 281 (1999-2001) a 999 (2008-2010). Las determinaciones de PSA ascendieron de 30.985 (1999-2001) a 117.396 (2008-2010). Conclusiones: Se observó un gran incremento de la frecuencia de CaP a expensas de los casos órgano-confinados, que correlacionan muy bien con las determinaciones de PSA llevadas a cabo en el ASL. No hubo diferencias de interés en la distribución municipal de las incidencias (AU)

Background: Prostate cancer (PC) is the most prevalent among men and yet its risk factors are little known. This article aims to determine the hospital incidence, trend and municipal distribution of PC in Health Area of León (HAL). Methods: We included new cases of prostate cancer (ICD-9: 185, ICD-10: C61) enrolled in the Hospital Tumor Registry of the Complejo Asistencial Universitario de León, between 1996 to 2010 with residence in HAL. We calculated crude triennial hospital incidences and adjusted at global and European population. As denominator we used the INE population data disaggregated by five-year age groups of residents in municipalities of the HAL. To analyze the spatial distribution, we estimated municipal relative risks (RR) smoothed by fitting the Besag, York and Mollié model and the posterior probability (PP) of RR > 1 using Bayesian methods. Results: 3,366 cases were included. Standardized rates at European population amounted of 30.3 (1996-98) to 119.0 (2008-2010) new cases per 100,000 men. The number of organ-confined cases were increased from 281 (1999-2001) to 999 (2008-2010). PSA determinations amounted from 30,985 (1999-2001) to 117 396 (2008-2010). Conclusions: A great increase was observed in the frequency of PC at the expense of organ-confined cases which correlate very well with PSA determinations performed in HAL. There were no differences of interest in the municipal distribution incidences (AU)

Con relación a la carta al director: Variabilidad de frecuencias de trastornos de la conducta alimentaria (TCA). ¿Problema de población o de instrumento? / No disponible

No disponible

Prevalencia de trastornos de la conducta alimentaria en universitarios españoles y factores asociados: proyecto uniHcos / Prevalence of eating disorders in college students and associated factors: uniHcos project

Introducción: Los trastornos de la conducta alimentaria (TCA) son especialmente frecuentes en los jóvenes. Objetivo: Determinar la prevalencia de TCA en jóvenes universitarios y sus factores asociados. Metodología: Estudio de prevalencia en jóvenes universitarios españoles del proyecto uniHcos. Mediante regresión logística no condicional se determinó la magnitud de la asociación entre los factores de riesgo asociados al estilo de vida y padecer un TCA medido mediante el cuestionario Sick, Control, One, Fat, Food (SCOFF). Resultados: La prevalencia de TCA fue del 19,5%, siendo mayor en mujeres (ORa=1,59; p=0,006). En los chicos, tener criterios de padecer TCA se asoció con vivir en colegios mayores, con realizar "binge drinking", y uso problemático de internet. En las mujeres el estudiar titulaciones diferentes a las ciencias de la salud (ORa=1,50) y el uso problemático de internet (ORa=2,33). Aquellas mujeres con riesgo de TCA presentaban con mayor frecuencia depresión (ORa=2,02), dolores menstruales (ORa=1,81) y mala salud percibida (ORa=1,70). En los hombres, aquellos con riesgo de TCA presentaban con mayor frecuencia una mala salud percibida (ORa=2,42). Conclusiones: El riesgo de obtener resultados positivos en el SCOFF en nuestro estudio es similar a lo publicado para otras poblaciones de estudiantes, así como su asociación con determinadas adicciones y problemas de salud. Se observaron diferencias en función del sexo que precisan atención en el diseño de estrategias de prevención y control (AU)

Introduction: eating disorders (ED) are particularly common in young people. Objective: To determine the prevalence of eating disorders in college students and its associated factors. Methods: Study of prevalence in young Spanish university uniHcos project. Using unconditional logistic regression have determined the magnitude of the association between the risk factors associated with lifestyle and ED measured by questionnaire Sick, Control, One, Fat, Food (SCOFF). Results: The prevalence of ED was 19.5%, being higher in women (ORa=1.59; p=0.006). In boys, have criteria of developing an eating disorder was associated with living in halls of residence, "binge drinking" and problematic Internet use. In women studying different courses at Health Sciences (ORa=1.50) and problematic Internet use (ORa=2.33). Those women at risk of ED more frequently had depression (ORa=2.02), menstrual pains (ORa=1.81) and perceived poor health (ORa=1.70). In men, those at risk for eating disorders more frequently had poor perceived health (ORa=2.42). Conclusions: The risk of a positive outcome in the scoff in our study is similar to that reported for other populations of students as well as their association with certain health problems and addictions. By gender differences that need attention in the design of prevention and control strategies were observed (AU)

Influencia del estatus profesional de los jugadores de fútbol en la frecuencia y gravedad de las lesiones: estudio piloto comparativo / Influence of the soccer players’ professional status on the frequency and severity of injuries: A comparative pilot study

Objetivo: El propósito del estudio es evaluar la frecuencia y la gravedad de las lesiones sufridas en un mismo equipo de fútbol durante 2 temporadas en 2 divisiones. Métodos: Estudio comparativo entre 2 estatus de fútbol profesional: Primera División (PD) y Segunda División (SD). La muestra consistió en jugadores profesionales de un mismo equipo cuyas lesiones se registraron prospectivamente durante las temporadas 2006-2007 (SD) y 2008-2009 (PD). Resultados: De las 101 lesiones registradas, 64 (63,4%) fueron consideradas leves, 26 (25,7%) moderadas y 11 (10,9%) graves. La incidencia de lesiones moderadas o graves durante el entrenamiento fue 3 veces mayor en la PD (3,36 vs 1,01; RR = 3,30), así como el total de lesiones durante el partido (52,82 vs 16,01; RR = 3,30). En cuanto a los días de baja, la incidencia fue mayor en PD, tanto en entrenamientos (60%) como en partidos (30%). El número de días perdidos por cada 1.000 h de exposición fue un 50% mayor en PD (129,60 vs 85,01 días/1.000 h de exposición). Conclusiones: Los resultados obtenidos muestran que en el fútbol español el estatus profesional puede ser un factor determinante de las lesiones. Además, estos resultados confirman el hecho de que el riesgo de lesión en el lugar de trabajo es considerablemente más alto en el fútbol profesional que en la mayoría de los demás sectores. Sería necesario que los clubes analizaran la importancia de desarrollar estrategias de prevención de lesiones y usaran recursos financieros para reducir el riesgo

Objective: The purpose of this study was to examine the frequency and severity of injuries sustained by members of a single soccer team over two seasons, when they played in the two divisions. Methods: Comparative study between two levels of professional soccer: the Spanish First Division (FD), and Second Division (SD). The original sample consisted of professional players of the same team whose injuries were prospectively recorded over the 2006-7 (SD) and 2008-9 (FD) seasons. Results: Of a total of 101 injuries registered, 64 (63.4%) were considered minor, 26 (25.7%) moderate, and 11 (10.9%) major. The incidence of moderate or major injuries during training was three times higher in FD (3.36 vs 1.01; RR = 3.30), as was the total number of injuries during match play (52.82 vs 16.01; RR = 3.30). As regards days lost, the incidence was higher in FD, in both training (60%) and matches (30%). The number of days lost per 1000 h exposure was 50% higher in FD (129.60 vs 85.01 days/1000 h exposure). Conclusions: The results show that in Spanish football, professional status may be a determining factor as regards injuries. These findings also confirm the fact that workplace injury risk is considerably higher in professional football than in most other sectors. It would therefore appear that clubs should take stock of the importance of developing injury prevention strategies, and use their financial resources to reduce the overall risk to clubs and players

Tendencia y distribución municipal de la incidencia de cáncer de mama en el área de salud de León (1996-2010) (AU) / Municipal distribution and trend of the incidence of breast cancer in the health area of León, Spain (1996-2010)

Fundamentos: El cáncer de mama es el más frecuente en las mujeres. El objetivo del presente estudio fue analizar la incidencia y distribución geográfica del cáncer de mama invasivo en el área de salud de León (ASL). Métodos: Estudio observacional descriptivo en el que se incluyeron mujeres con diagnóstico de neoplasia maligna de mama (CIE-9:174, CIE-10:C50) del Registro Hospitalario de Tumores del Centro Asistencial Universitario de León, entre 1/1/1996 y 31/12/2010 y con residencia en el ASL. Para el análisis de la distribución espacial se estimaron los riesgos relativos (RR) municipales suavizados mediante el ajuste del modelo de Besag, York y Mollié y sus probabilidades posteriores de que los RR fuesen >1 (PP), utilizando métodos bayesianos. Resultados: Se incluyó un total de 2.379 casos. El número de casos nuevos y las tasas de incidencia brutas en cada trienio fueron de 72,7 (1996-1998) a 101,5 (2008-2010) por 100.000 mujeres. Las tasas a población europea por 100.000 mujeres ascendieron de 58,0 en el primer trienio y a 69,4 en el último. Se observó un incremento anual promedio del 1,3 %. Varios municipios del ASL presentaron riesgos superiores al 10 %. Las PP solo fueron superiores a 0,9 en el municipio de León. Conclusiones: Las tasas observadas son de las más bajas de España. Sin embargo, el número de casos y las tasas de incidencia se incrementaron de manera mantenida en el periodo estudiado (AU)

Background: Breast cancer is the most common amongst women. The aim of this study was to analyze the incidence and geographical distribution of breast cancer in the health area of León. Methods: We designed an observational descriptive study that included women enrolled in the Hospital Tumor Registry of the Centro Asistencial Universitario in León with a diagnosis of breast malignant neoplasm (ICD-9:174, ICD-10:50) between 01/01/1996 and 31/12/2010 and resident in the health area of León. To study the spatial distribution, we estimated municipal relative risks (RR) smoothed by fitting the Besag, York and Mollié model and the posterior probability (PP) of RR > 1 using Bayesian methods. Results: A total of 2379 cases were included. The number of new cases and the crude incidence rate have both increased in every triennium, from 72,7 (1996-1998) to 101,5 (2008-2010) per 100,000 women. The age adjusted rates per 100,000 women (European standard population) increased from 58,0 during the first triennium to 69,4 during the last one. An average annual increase of 1,3 % was observed. Several municipalities from the health area of León showed risks higher than a 10 %. The PP were higher than 0.9 only in the municipality of León. Conclusion: The observed rates are among the lowest in our country. Nevertheless, the number of cases and the incidence rates have increased progressively (AU)

Proyecto Unihcos cohorte dinámica de estudiantes universitarios para el estudio del consumo de drogas y otras adicciones / UniHcos project. Dynamic cohort of spanish college students to the study of drug and other addictions

La etapa universitaria da lugar a cambios sociales y personales, que se relacionan con la adquisición y/o consolidación de estilos y hábitos de vida que pueden determinar el estado de salud futuro. Una inadecuada nutrición, un alto nivel de sedentarismo, conductas sexuales de riesgo, el abuso de las nuevas tecnologías o el inicio en el consumo de drogas tanto legales como ilegales, son algunas de las conductas más destacables de esta etapa. Con el objeto de conocer cómo se establecen y consolidan los hábitos y estilos de vida en la etapa universitaria y sus efectos sobre la salud futura nace el proyecto uniHcos. Se trata del estudio de una cohorte dinámica de estudiantes universitarios que se incorporan al proyecto durante el primer curso académico y serán seguidos durante su permanencia en la universidad y vida laboral. El seguimiento se realizará bienalmente y para la captación y recogida de información se utilizarán las nuevas tecnologías on-line. El objetivo del presente trabajo es dar a conocer el proyecto uniHcos a la comunidad científica así como presentar los resultados preliminares encontrados hasta el momento en las dos cohortes establecidas desde el 2011 (AU)

The University stage gives rise to social and personal changes as the independence of the nuclear family and the increased responsibilities that are related to the acquisition and / or consolidation of life styles and habits that may determine the future health status. Inadequate nutrition, a high level of inactivity, risky sexual behavior, abuse of new technologies or starting consumption of legal and illegal drugs, are among the most significant risk behaviors in this phase. In order to know how to set and / or consolidate the habits and lifestyles in the university stage and health effects in the future, to born the uniHcos project. It is a dynamic cohort of university students who join the project during the first academic year and will be followed during their stay at college and working life. The follow-up will be biennially and for the capture and the information collection will be used on-line technologies. This paper aims to show the uniHcos project to the scientific community aswell as present preliminary results found so far in the two cohorts established since 2011 (AU)

Una historia de éxito: nuevas reglas y menos lesiones en la Lucha Leonesa (2005-2012) / A success story: New rules and fewer injuries in traditional Leonese Wrestling (2006-2012)

Objective: To analyse the effectiveness of a change in the rules on the incidence of injuries in traditional Leonese Wrestling (LW). Material and methods: Cohort study, retrospective (2006–2007) and prospective (2008–2012). The population studied comprised all the male wrestlers over 16 years of age who took part in Winter League competitions in the seasons 2006–2012. Data collected included the number, location and severity of injuries. Classifying them according to location and severity, the incidence of injuries by bouts and falls before and after the change was calculated. The formula for calculating effectiveness was: 1 - relative risk. Results: Over the 7 seasons, a total of 34 injuries were reported - 9 in the seasons before the change and 25 afterwards. Since the introduction of the new regulations in 2008, no serious upper limb injuries have been reported. Before the change in rules there was an incidence of 10.4 per 1000 bouts and 3.9 for every 1000 falls, the differences being statistically significant (P = 0.002 and P = 0.006, respectively). The effectiveness in reducing the incidence of serious injuries was 94% by bouts, and 91% by falls. Conclusions: The results of this study confirm the importance of a methodological approach for the prevention of injuries; in this case a change in the rules (AU)

Objective: To analyse the effectiveness of a change in the rules on the incidence of injuries in traditional Leonese Wrestling (LW). Material and methods: Cohort study, retrospective (2006–2007) and prospective (2008–2012). The population studied comprised all the male wrestlers over 16 years of age who took part in Winter League competitions in the seasons 2006–2012. Data collected included the number, location and severity of injuries. Classifying them according to location and severity, the incidence of injuries by bouts and falls before and after the change was calculated. The formula for calculating effectiveness was: 1 – relative risk. Results: Over the 7 seasons, a total of 34 injuries were reported — 9 in the seasons before the change and 25 afterwards. Since the introduction of the new regulations in 2008, no serious upper limb injuries have been reported. Before the change in rules there was an incidence of 10.4 per 1000 bouts and 3.9 for every 1000 falls, the differences being statistically significant (P = 0.002 and P = 0.006, respectively). The effectiveness in reducing the incidence of serious injuries was 94% by bouts, and 91% by falls. Conclusions: The results of this study confirm the importance of a methodological approach for the prevention of injuries; in this case a change in the rules (AU)

Introducción: El objetivo de nuestro estudio es analizar la efectividad de un cambio de reglamento en la incidencia de lesiones de Lucha Leonesa. Material y métodos: Estudio de cohorte retrospectivo (2006-2007) y prospectivo (2008-2012). La población estudiada comprendió todos los luchadores masculinos de más de 16 años que participaron en las Ligas de Invierno en las temporadas del 2006-2012. Se recogieron datos sobre el número, la localización y la severidad de las lesiones, clasificándolos según su localización y su gravedad. Se calculó la incidencia de lesiones por combates y por caídas antes y después del cambio de reglamento. La fórmula para calcular la efectividad fue: 1 - Riesgo Relativo. Resultados: En las 7 temporadas, se registraron un total de 34 lesiones, 9 antes del cambio de reglamento y 25 después. Desde la introducción de las nuevas reglas en 2008 no se produjo ninguna lesión grave en los miembros superiores, mientras que antes del cambio de reglamento la incidencia de lesiones fue de 10,4 por cada 1000 combates y de 3,9 por cada 1000 caídas, siendo estadísticamente significativa (p= 0,002 y p=0,006). La efectividad de la reducción de la incidencia de lesiones graves fue del 94% por combates y del 91% por caídas. Conclusiones: Los resultados de este estudio confirman la importancia de un enfoque metodológico para la prevención de lesiones; en este caso, los cambios de reglamento (AU)

Tendencia y distribución municipal de la incidencia de cáncer de estómago en el área de salud de León (1994-2008) / Municipal distribution and trend of the incidence of stomach cancer in the health area of León, Spain (1994-2008)

Fundamento El cáncer de estómago es frecuente y de elevada mortalidad. El objeto del presente estudio fue analizar la incidencia y la evolución temporal del cáncer gástrico en el área de salud de León. Métodos Se diseñó un estudio observacional descriptivo en el que fueron incluidas las personas con diagnósticos de neoplasia maligna de estómago (CIE-9, 151, y CIE-10, C16) del Registro Hospitalario de Tumores del Centro Asistencial Universitario de León, entre 1/1/1994 y 31/12/2008 con residencia en el área de salud de León. Como denominador de población se utilizó la suministrada por el INE (censos y padrones). La tendencia temporal se evaluó con un modelo de regresión de Poisson. Para el análisis de la distribución espacial se estimaron los riesgos relativos (RR) municipales suavizados mediante el ajuste del modelo de Besag, York y Mollié y sus probabilidades posteriores (PP) de que los RR fuesen > 1 (PP), utilizando métodos bayesianos. Resultados Se incluyeron 1.680 casos. La tasa de incidencia bruta promedio fue de 40,0 casos nuevos por 100.000 en hombres y de 23,5 en mujeres. La incidencia disminuyó un 1,4% anualmente (hombres: 1,2%; mujeres: 1,8%). Las tasas estandarizadas con población europea descendieron de 26,9 (1994-1996) a 22,2 casos nuevos por 100.000 hombres (2006-2008) y de 13,3 a 9,5 en las mujeres. En 3 zonas geográficas los RR fueron más elevados y las PP superiores a 0,9.ConclusionesLas tasas observadas son de las más elevadas de España y su descenso inferior a lo esperado. Se observó exceso de riesgo en algunos municipios (AU)

Background: Stomach cancer is common and has a high mortality rate. The aim of this study was to analyze the incidence and trend of gastric cancer in the health area of León. Methods: We designed an observational descriptive study that included patients enrolled in the Hospital Tumor Registry of the Centro Asistencial Universitario de León with a diagnosis of malignant neoplasm of the stomach (ICD 9-151, ICD10-C16) between 01/01/1994 and 12/31/2008 and resident in the health area of León. The population supplied by Spain’s National Institute of Statistics was used as the denominator. The time trend was evaluated with a Poisson regression model. To study the spatial distribution, we estimated municipal relative risks (RR) smoothed by fitting the Besag, York and Mollié model and the posterior probability (PP) of RR > 1 using bayesian methods. Results: A total of 1680 cases were included. The average crude incidence rate was 40.0 new cases per 100,000 in men and 23.5 for women. The incidence decreased by 1.4% per year (men:1.2%, women: 1.8%). The age adjusted rates (European standard population) decreased from26.9 (1994-6) to 22.2 (2006-8) new cases per 100,000 population in men and from 13.3 to 9.5in women. Three geographical areas showed a RR excess with a PP higher than 0.9.Conclusions: The observed rates are among the highest in Spain and their declining trend islower than expected. Some municipalities had an excess risk (AU)